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opps: skin substitute payment history — APC to flat rate transition #266

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opened 2026-03-25 19:54:09 +00:00 by kert · 0 comments
kert commented 2026-03-25 19:54:09 +00:00
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Objective

Track how skin substitute payment has evolved under OPPS specifically.

Tasks

  • Status indicator history: when skin subs moved between S/T indicators
  • APC assignment history: which APCs covered skin subs by year
  • Pass-through to packaged to separate payment transitions
  • High-cost vs low-cost category (CY 2023–2025) payment differentials
  • Jan 2026 reclassification: APC → flat $127.28/cm²
  • Compare OPPS vs PFS payment for same product/code
## Objective Track how skin substitute payment has evolved under OPPS specifically. ## Tasks - [ ] Status indicator history: when skin subs moved between S/T indicators - [ ] APC assignment history: which APCs covered skin subs by year - [ ] Pass-through to packaged to separate payment transitions - [ ] High-cost vs low-cost category (CY 2023–2025) payment differentials - [ ] Jan 2026 reclassification: APC → flat $127.28/cm² - [ ] Compare OPPS vs PFS payment for same product/code
kert added this to the P31: OPPS Module — outpatient payment system parity with PFS milestone 2026-03-25 19:54:09 +00:00
kert closed this issue 2026-03-26 06:14:37 +00:00
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Reference: homelab/stack#266
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